Residency Mini-fellowships in the PGY-5 Year: Is There Added Value?

Mentoring in radiology: An asset worth exploring!

Residents experience high pressure to be successful in both their career and in keeping up an optimal work-life balance. With a mentoring program, faculties can alleviate stress and provide help for their residents. It is now well established that mentor-mentee relationships during medical school, have influence in career decisions and professional identity formation. The same can be said for mentor-mentee relationships during radiology residency. In general, universal rules of mentoring are also useful and applicable in the field of radiology. These universal rules for establishing a successful mentoring relationship include creating a relationship of trust and confidentiality, clearly defining roles and responsibilities, establishing short- and long-term goals, using open and supportive communication, and collaboratively solving problems. The institutions and the radiology departments should be well prepared and aware of the responsibility to have trainees, providing time for mentors to dedicate to their academic duties. They have to implement strategies to effective mentor matching and orientation as well as the ability to provide evaluation with qualitative feedback. Periodic assessment should be warranted together with the incorporation of new technology as it plays a critical role in the training of millennial radiologists as they take the profession into a technology-laden future of medical imaging.

Otolaryngology Residents' Attitudes, Experiences, and Barriers Regarding the Medical Research

Objective:

It was aimed to investigate the attitudes, experiences, and barriers towards scientific research among otolaryngology residents in Turkey.

Methods:

Anonymous data were collected via an online survey. The demographic characteristics and experience in scientific research were investigated in the first section of the survey. The attitudes of participants towards scientific research and the barriers to the scientific research were examined in the second section of the survey using 17 items.

Results:

The present study involved 119 otolaryngology residents continuing their education. It was determined that 68.1% of participants think that “participating in scientific research” is a part of otolaryngology training. In the present study, it was shown that the residents having journal club hours in clinics on regular basis participated in various steps of scientific research projects (p<0.05). Residents stated that they participated in the “literature review” stage of the preparation of a scientific publication (mean value of 2.58±1.88) most and in “verbal presentation in a congress” least (mean value of 0.74±1.44). It was determined that 80.7% of participants have not attended in any training on scientific research. It was found that the residents receiving structured scientific research training participated more in steps of scientific research projects which was statistically significantly (p<0.05).

Conclusion:

In our country, otolaryngology residents are very enthusiastic about having research education and participating in researches. However, residency students frequently have time deficiency, lack of knowledge-skill, and lack of financial support. Dedicated time should be allocated for research training and practice in specialty programs. Journal club activities should be organized on regular basis and integrated with research education. On the other hand, the scholarly activities of residents should be supported by means of various countrywide educational activities on research training.

Evolution of the Interventional Radiology (IR) Pathway-Various Changes and Interrelation to Diagnostic Radiology (DR)

Interventional radiology continues to evolve into a more robust and clinically dynamic specialty underpinned by significant advancements in training, education, and practice. This article, prepared by members of the 2020-2021 Association of University Radiologists' task force of the Radiology Research Alliance, will review these developments, highlighting the evolution of interventional radiology pathways with attention to growing educational differences, interrelation to diagnostic radiology training, post-training practice patterns, distribution of procedures and future trends, amongst other key features important to those pursuing a career in interventional radiology as well as those in practice.

The Evolving Status of Fellowships and Mini-Fellowships in Diagnostic Radiology: A Survey of Program Directors and Chief Residents

RATIONALE AND OBJECTIVES

Recent changes in radiology fellowships include musculoskeletal radiology adopting a match system, interventional radiology transitioning away from diagnostic radiology to offer direct-entry programs, and a common fellowship application timeline created by the Society for Chairs of Academic Radiology Departments (SCARD). The concept of mini-fellowships has also emerged with the elimination of the oral American Board of Radiology examinations that had been administered in the final year of residency training prior to 2014. This paper seeks to assess the opinions of fellowship program directors, residency program directors, and chief residents regarding these recent changes.

MATERIALS AND METHODS

This is a cross-sectional study using a web-based survey posed to fellowship program directors, residency program directors, and chief residents in 2020. Questions sought to explore current attitudes toward the following topics: (1) a common fellowship application timeline; (2) a common fellowship match; and (3) the status of mini-fellowships in diagnostic radiology. In addition, the number of fellowship positions for each subspecialty was estimated using subspecialty society directories, Accreditation Council for Graduate Medical Education (ACGME) data, and individual program websites.

RESULTS

Deidentified responses were collected electronically and aggregated. The three respondent groups preferred a common fellowship application timeline at rates of 67% among fellowship program directors, 80% residency program directors, and 74% residents. A common match system across all subspecialties was preferred at rates of 50% fellowship program directors, 74% residency program directors, and 26% chief residents. There was widespread reported compliance with the SCARD fellowship timeline policy. Subspecialty programs using the match system reported interviewing greater numbers of applicants per position. Fellowship directors and chief residents reported that the most common duration of mini-fellowship experiences was 2 to 3 months.

CONCLUSION

There is a division between chief residents and program directors regarding the preference for a common radiology match. Adopting a radiology-wide fellowship match would increase the number of interviews required. The SCARD fellowship timeline policy has been successful, and there is support across stakeholders regarding the common timeline. Mini-fellowships are highly variable in length and structure.

Resident Wellness in Radiology as Portrayed by Departmental Websites

RATIONALE AND OBJECTIVES

Departmental websites are often the first exposure applicants have in researching programs. Websites provide information about resident education as well as infrastructure for resident wellness. For this study, we reviewed residency websites to evaluate resident wellness initiatives and extent of details available online.

MATERIALS AND METHODS

Program websites for diagnostic radiology residencies listed in the 2020 ERAS program list were evaluated for 26 criteria pertaining to resident wellness. Criteria which are not radiology resident specific were also evaluated on their graduate medical education (GME) websites if unavailable on the departmental website.

RESULTS

Of 189 programs, 185 (97.9%) had functioning websites for review. Book funds were mentioned by 57% (mean $3,762), and 43.5% discussed housing stipends during AIRP (mean $2,204); neither significantly correlated with program size. Retirement plan matching was present for 47.8% of programs. Almost all programs utilized night float call schedules, with relatively similar distribution of residents starting on-call duties as fall PGY2s, spring PGY2s, and starting PGY3s. Moonlighting was mentioned by 22.8% of departments. Paid wellness days were discussed in 10.8% (mean 3.1 days/year), and 37.7% described paid parental leave (mean 27.8 days/year). Less than 10% described resident mentoring, wellness committees, or non-clinical curricula. Resident retreats were mentioned by 21.6% of programs, and 11.4% described regular social activities; both were found more frequently at larger programs (chi-square analysis, p <0.00625).

CONCLUSION

This study evaluated radiology residency program and GME websites for information pertaining to resident wellness. While financial and clinical information was typically present for >50% of programs, information regarding social initiatives was generally lacking and may be one area to bolster resident wellness and describe on websites.

Resident Experiences With Virtual Radiology Learning During the COVID-19 Pandemic

Rationale and Objectives

COVID-19 has disrupted radiology education and forced a transition from traditional in-person learning to a virtual platform. As a result of hospital and state mandates, our radiology residency program quickly transitioned to a virtual learning platform to continue dissemination of knowledge, maintain resident engagement, and ensure professional development. The goal of this study is to assess the strengths and weaknesses of the virtual learning platform at our institution using resident ratings.

Materials and Methods

This institutional IRB-exempt study involved a survey of 17 questions which was electronically distributed to 45 radiology residents using SurveyMonkey. Questions encompassed resident satisfaction with teaching and professional development, scheduling changes, and engagement with the virtual platform. Answers to most questions were submitted on a Likert scale.

Results

A total of 31 of 45 respondents completed the survey (response rate = 69%). Most residents were satisfied with the virtual platform with teaching activities identified as a strength and the incorporation of professional development as a weakness. The most frequent barriers to attending the virtual curriculum were technical difficulties (43%) and childcare (36%). Residents who reported experiencing barriers were less likely to adhere to the virtual curriculum (p = 0.004). Most respondents (81%) reported a desire to maintain elements of the virtual learning practice postpandemic.

Conclusion

The majority of residents reported high satisfaction with virtual learning during the COVID-19 pandemic. Teaching activities are a curricular strength. Weaknesses identified include the incorporation of professional development and extrinsic barriers, such as technical difficulties and family obligations, which require further support for trainees.

Dedicated Residency Research Time and Its Relationship to Urologic Career Academic Success

OBJECTIVE

To explore the relationship between research time during urologic training and career academic success.

METHODS

We included urologists graduating residency between 2002 and 2008 from 36 programs affiliated with a top 50 hospital for urology as ranked by the United States News and World Report, and collected research time during residency, fellowship training, current appointment (private practice, assistant professor, associate professor, professor, chair), national institutes of health (NIH) grant accrual, NIH R01 grant accrual, and current H-index in Scopus database. Publication output during and after residency was identified through the PubMed database.

RESULTS

In our cohort of 543 urologists, 66.3% of graduating trainees pursued private practice. Increasing residency research time was associated with increased publication count (P <.001), pursuit of professor positions (P <.001), and NIH funding (P <.001). One year of dedicated research increased the odds of being in the top 10th percentile of publication output during residency (odds ratio [OR]: 5.7, 95% confidence interval [CI]: 2.7-12.1), pursuing a fellowship (OR: 2.0, 95% CI: 1.3-3.1), promotion to professor (OR: 4.9, 95% CI: 2.0-12.2), obtaining a NIH grant (OR: 6.2, 95% CI: 2.3-16.5), and decreased the odds of pursuing private practice (OR: 0.4, 95% CI: 0.3-0.6). As amount of time dedicated to research in urologic residency increased from 3-4 to 6-12 months, OR increased for career academic success metrics.

CONCLUSION

Although a minority of trainees enter academics, dedicated time for research in urologic residency is associated with career academic success, with more research time associated with increased publication output, academic appointments, and grant funding.

Preparing Radiologists to Lead in the Era of Artificial Intelligence: Designing and Implementing a Focused Data Science Pathway for Senior Radiology Residents

Artificial intelligence and machine learning (AI-ML) have taken center stage in medical imaging. To develop as leaders in AI-ML, radiology residents may seek a formative data science experience. The authors piloted an elective Data Science Pathway (DSP) for 4th-year residents at the authors' institution in collaboration with the MGH & BWH Center for Clinical Data Science (CCDS). The goal of the DSP was to provide an introduction to AI-ML through a flexible schedule of educational, experiential, and research activities. The study describes the initial experience with the DSP tailored to the AI-ML interests of three senior radiology residents. The authors also discuss logistics and curricular design with common core elements and shared mentorship. Residents were provided dedicated, full-time immersion into the CCDS work environment. In the initial DSP pilot, residents were successfully integrated into AI-ML projects at CCDS. Residents were exposed to all aspects of AI-ML application development, including data curation, model design, quality control, and clinical testing. Core concepts in AI-ML were taught through didactic sessions and daily collaboration with data scientists and other staff. Work during the pilot period led to 12 accepted abstracts for presentation at national meetings. The DSP is a feasible, well-rounded introductory experience in AI-ML for senior radiology residents. Residents contributed to model and tool development at multiple stages and were academically productive. Feedback from the pilot resulted in establishment of a formal AI-ML curriculum for future residents. The described logistical, planning, and curricular considerations provide a framework for DSP implementation at other institutions. Supplemental material is available for this article. © RSNA, 2020.

Characteristics of musculoskeletal radiology job postings to guide radiology trainees

OBJECTIVE

To review current musculoskeletal (MSK) job market postings to define the listed requirements for practice in order to provide insight to guide residents pursuing fellowship training in MSK radiology to best meet the needs of potential future employers.

METHODS

Utilizing the ACR (American College of Radiology) Career Center, a review of the ACR job postings began 6/1/2018 focusing on jobs labeled as musculoskeletal (MSK) subspecialty. E-mail notifications from the career center were reviewed, and jobs were tracked prospectively for 1 year. Data was collected regarding the number of positions, the location, the practice type, and required skills both within musculoskeletal radiology and within the remainder of the radiology subspecialties.

RESULTS

456 postings met the inclusion criteria. Approximately 19% were for a dedicated MSK radiologist, 25% sought a combination of MSK and a general skill set, and 56% were specifically for a general radiologist position. Approximately 29% of jobs require some combination of mammography and/or light interventional radiology (IR).

DISCUSSION

Our results indicate that majority of job postings for musculoskeletal radiology require a practice that is not specifically limited to MSK, mirroring trends in other radiology subspecialties. Radiology trainees and program directors should be aware of the needs being demanded by the job market to help guide trainees to individualize their training to best meet the needs of their future employment.

Global Radiology Training Prevalence Among Radiology Residency Programs

OBJECTIVE

Global Radiology aims to enhance access to medical imaging services and education, worldwide. To date, few reports have evaluated Global Radiology Training (GRT) in radiology residency programs. Here, we examined how radiology residency programs perceive and incorporate GRT into their curriculum, and how this information is promoted online.

METHODS

Two methods were used to examine the current state of GRT. First, radiology residency program directors (identified via the Association of Program Directors in Radiology) were surveyed on topics including: Electives, institutional partnerships, resident and faculty involvement, inquiry by prospective residents, and barriers to implementation. Second, radiology residency program websites (n = 193) were examined for existing GRT on the programs' publicly available webpages.

RESULTS

There were 62 survey responses (response rate of 19%). Thirty-eight percent (24/62) of residency programs offered a Global Radiology elective to their residents within the past academic year and 27% (17/62) of programs have active affiliations with medical institutions outside of the United States. Eighty-four percent of program directors (52/62) received questions from residency applicants regarding opportunities to participate in Global Radiology. Furthermore, only 13% (26/193) of all radiology residency programs listed at least one GRT elective on their webpage.

DISCUSSION

GRT in radiology residency is more widely available than previously reported and has been underrepresented on residency program websites. In the present survey, the majority of radiology residency program directors reported that radiology is an important component of Global Health, one-third of whom have already incorporated the subject into their curriculum. However, most common barriers to GRT include, perceived lack of time in the curriculum and lack of faculty interest. The high prevalence of inquiry from residency program applicants about GRT suggests that it may be a notable factor for applicants during the ranking process. Programs build up GRT may choose to share related information seeking to may choose to emphasize work in Global Radiology on their program webpages.

Advanced Quality Training in Radiology: Inaugural Report of a 2-Year Program

OBJECTIVE. The purpose of this study is to describe and analyze the outcomes of a 2-year advanced quality training program for radiology residents. MATERIALS AND METHODS. In 2016, the radiology quality committee of a quaternary health system created a hands-on 2-year advanced quality training curriculum for diagnostic and interventional radiology residents. Internal candidates with the following prerequisites submitted competitive applications: registration for a 2-day lean health care management course, completion of four or more Radiological Society of North America (RSNA) quality essentials certificates, identification of faculty mentor(s), selection of one quality improvement project to champion, and completion of a two-page essay summarizing interest in quality improvement, the proposed project, and its potential impact. Residents were required to attend monthly quality meetings, pursue their project and its derivatives, submit completed work for consideration to a national meeting and for publication, and present at departmental grand rounds. Outcomes were summarized using descriptive statistics. RESULTS. Five residents submitted four projects for consideration, and all five were selected. In addition to the four submitted projects, seven additional projects were pursued. Participants worked on nine local and three multicenter process improvements, gave one to two grand rounds each, presented three oral and five poster presentations, generated eight publications, received three awards, formed 14 mentor-mentee relationships, and influenced local and multisite practice patterns. Participants reported gaining firsthand experience in quality improvement principles and developing real-world leadership skills. CONCLUSION. A targeted 2-year curriculum emphasizing hands-on quality improvement experience with rich mentor-mentee relationships can produce meaningful results.